06-4189 (SFD)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T4ht 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 06-00004189
Property Address: 80197 VIA TESORO
APN: 772-250-018-15 -31349 -
Application description: DWELLING - SINGLE FAMILY DETACHED
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 227594
Applicant: /architect or Engineer:
-----------------7--------------------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
Lic a Class: B 4Lirense 777699
t
Date: In+� tracor:ATIOOWNER.BUILDER N I
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031 .5 by
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
1 _ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
and who does the work himself or herself through his or her own employees, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
one year of completion, the owner -builder will have the burden of proving that he or she did not build or
improve for the purpose of sale.).
(_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
( ) I am exempt under Sec. , B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address: tit r\
LQPERDIIT
Owner:
TOLL CA V
C/O KEVIN D DUERMIT
8901 E MOUNTAIN VIEW 200
SCOTTSDALE, AZ 85258
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/04/06
Contractor:
TOLL BROS, INC. DECc
73121 FRED WARING DRIVE, #1 0 6 �006
PALM DESERT, CA 92260 /�
(760) 674-9699 C' OFiAou/N��
LiC. No.: 777699 C•NRD1r
-----------------------------------------------
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
�Thave and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier ZURICH AMERICAN Policy Number WC387821301
I certify that, in the performance of the work for which this permit is issued, 1 shall not employ any
person in any manner so as to become subject to the workers' compensation laws of California,
and agree that 1 should ecome subject to the workers' compensation provisions of Section
3700 of th abor Code, shall forthwith c mply ith those provisions.
ate:IZ'Z` Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATIO COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
conditions and restrictions set forth on this application.
1 . Each person upon whose behalf this application is made, each person at whose request and for
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Quinta, its officers, agents and employees for any act or omission related to the work being
performed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is not commenced
within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the above information is correct. I agree to comply with all
city and ounty ordinances a state laws relating to building construction, and hereby authorize representatives
Of thi oun�ente,the above-mentioned property r inspection pute: .re (Applicant or Agent):
Application Number . . . . . 06-00004189
Permit . . .
Additional desc . .
Permit Fee . . . .
Issue Date . . . .
Expiration Date . .
Qty Unit Charge
2631.00 .0350
LQPERMIT
ELEC-NEW RESIDENTIAL
116.99 Plan Check Fee .
Valuation . . .
6/02/07
Per
BASE FEE
ELEC NEW RES - 1 OR 2 FAMILY
29.24
0
Extension
15.00
92.09
Structure Information
Construction Type . .
. . TYPE V - NON RATED
Occupancy Type . . .
. . . DWELLG/LODGING/CONG <=10
Flood Zone . .
. . . NON -AO FLOOD ZONE
Other struct info . .
. . . CODE EDITION
2001 CBC
# BEDROOMS
3.00
FIRE SPRINKLERS
NO
GARAGE SQ FTG
495.00
PATIO SQ FTG
399.00
NUMBER OF UNITS
1.00
----------------------------------------------------------------------------
1ST FLOOR SQUARE FOOTAGE
2631.00
Permit . . .
BUILDING PERMIT
Additional desc .
Permit Fee . . . .
1087.50 Plan Check Fee
706.88
Issue Date . . . .
Valuation . .
. . 227594
Expiration Date . .
6/02/07
Qty 'Unit Charge
Per
Extension
BASE FEE
639.50
128.00 3.5000
----------------------------------------------------------------------------
THOU BLDG 100,001-500,000
448.00
Permit . . .
MECHANICAL
Additional desc . .
Permit Fee . . . .
109.50 Plan Check Fee
27.40
Issue Date . . . .
Valuation . .
. . 0
Expiration Date . .
6/02/07
Qty Unit Charge
Per
Extension
BASE FEE
15.00
2.00 9.0000
EA MECH FURNACE <=100K
18.00
2.00 9.0000
EA MECH B/C <=3HP/100K BTU
18.00
8.00 6.5000
EA MECH VENT FAN
52.00
1.00 6.5000
----------------------------------------------------------------------------
EA MECH EXHAUST HOOD
6.50
Permit . . .
Additional desc . .
Permit Fee . . . .
Issue Date . . . .
Expiration Date . .
Qty Unit Charge
2631.00 .0350
LQPERMIT
ELEC-NEW RESIDENTIAL
116.99 Plan Check Fee .
Valuation . . .
6/02/07
Per
BASE FEE
ELEC NEW RES - 1 OR 2 FAMILY
29.24
0
Extension
15.00
92.09
Application Number . . . . . 06-00004189
Permit . . . . . . ELEC-NEW RESIDENTIAL
Qty Unit Charge Per Extension
495.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 9.90
----------------------------------------------------------------------------
Permit . . .
Additional desc . .
Permit Fee . . . .
Issue Date . . . .
Expiration Date . .
PLUMBING
189.00
6/02/07
Plan Check Fee . . 47.24
Valuation . . . . 0
Qty
Unit Charge
Per
BASE FEE
Extension
----------------------------------------------------------------------------
Special Notes
and Comments
BASE FEE
15.00
20.00
6.0000
EA
PLB
FIXTURE
120.00
1.00
15.0000
EA
PLB
BUILDING SEWER
15.00
1.00
7.5000
EA
PLB
WATER HEATER/VENT
7.50
1.00
3.0000
EA
PLB
WATER INST/ALT/REP
3.00
1.00
9.0000
EA
PLB
LAWN SPRINKLER SYSTEM
9.00
6.00
.7500
EA
PLB
GAS PIPE >=5
4.50
1.00
----------------------------------------------------------------------------
15.0000
EA
PLB
GAS METER
15.00
Permit . . . GRADING PERMIT
Additional desc . .
Permit Fee . . . . 15.00
Issue Date . . . .
Expiration Date . . 6/02/07
Plan Check Fee . . .00
Valuation . . . . 0
Qty Unit
Charge Per
Extension
BASE FEE
15.00
----------------------------------------------------------------------------
Special Notes
and Comments
SFD - LOT 15.
2631 S.F.CAMINA-SB PERMIT
DOES NOT INCLUDE BLOCK WALLS, POOL/SPA,
OR DRIVEWAY APPROACH.2001
CBC, CMC,
CPC, 2004 CEC,
2005 ENERGY CODES
----------------------------------------------------------------------------
Other Fees .
. . . . . . . . ART IN PUBLIC PLACES -RES
68.98
DIF COMMUNITY CENTERS -RES
74.00
DIF CIVIC CENTER - RES
995.00
ENERGY REVIEW FEE
17.67
DIF FIRE PROTECTION -RES
140.00
GRADING PLAN CHECK FEE
.00
DIF LIBRARIES - RES
355.00
DIF PARK MAINT FAC - RES
22.00
DIF PARKS/REC - RES
892.00
STRONG MOTION (SMI) - RES
22.75
I.QPERI.IIT
Application Number . . . . . 06-00004189
Other Fees . . .
. . . . . .
DIF STREET
MAINT FAC -RES
67.00
DIF TRANSPORTATION - RES
1930.00
Fee summary
-----------------
Charged
----------
Paid
----------
Credited
--------------------
Due
Permit Fee Total
1517.99
.00
.00
1517.99
Plan Check Total
810.76
.00
.00
810.76
Other Fee Total
4584.40
.00
.00
4584.40
Grand Total
6913.15
.00
.00
6913.15
LQPERNIIT